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OMB APPROVAL
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- -------- OMB Number: 3235-0104
FORM 3 Expires: April 30, 1997
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hours per response .... 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a)
of the Public Utility Holding Company Act of 1935 or Section 30(f)
of the Investment Company Act of 1940
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<S> <C> <C> <C>
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1. Name and Address of Reporting Person 2. Date of Event Requiring 4. Issuer Name and Ticker or Trading Symbol
Diaz Edwin Statement Enamelon, Inc. (ENML)
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(Last) (First) (Middle) 10/23/96 5. Relationship of Reporting 6. If Amendment, Date
758 Route 18 North, #102 ---------------------------- Person to Issuer of Original
- ---------------------------------------- 3. IRS or Social Security (Check all applicable) (Month/Day/Year)
(Street) Number of Reporting ----- Director ----- 10% Owner
Person (Voluntary) X
East Brunswick New Jersey 08816 ----- Officer ----- Other (specify
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(City) (State) (Zip) Vice President, CFO and Treasurer
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TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect
(Instr. 4) Beneficially Owned Direct (D) or Beneficial
(Instr. 4) Indirect (I) Ownership (Instr. 5)
(Instr. 5)
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None
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
SEC 1473 (8/92)
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FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C>
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1. Title of Derivative Security 2. Date 3. Title and Amount of 4. Conver- 5. Owner- 6. Nature of Indirect
(Instr. 4) Exercisable and Securities Underlying sion or ship Beneficial Ownership
Expiration Date Derivative Security Exercise Form of (Instr. 5)
(Month/Day/ (Instr. 4) Price of Deriv-
Year) Deri- ative
vative Security:
Security Direct
------------------------------------------------- (D) or
Date Expira- Amount or Indirect (I)
Exercis- tion Title Number (Instr. 5)
able Date of Shares
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Options (right to buy) 7/29/97 7/29/01 Common Stock, 12,500 * D
$.001 par value
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7/29/98 7/29/01 Common Stock, 12,500 * D
$.001 par value
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* The exercise Price shall be equal to the public offering price of the Common Stock on the effective date of the
Form S-1 Registration Statement or if such Registration Statement is not effective by January 1, 1997,
$8.00 per Share.
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Explanation of Responses:
/s/ Edwin Diaz 10/22/96
**Intentional misstatements or omissions of facts constitute Federal Criminal ------------------------------- -------------
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). **Signature of Reporting Person Date
Edwin Diaz
Note. File three copies of this Form, one of which must be manually signed. Page 2
If space provided is insufficient, See Instruction 6 for procedure. SEC 1473 (8/92)
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